Erectile dysfunction — the inability to get or maintain an erection firm enough for sex — is common in men who have diabetes. It can stem from problems caused by poor long-term blood sugar control, which damages nerves and blood vessels. Erectile dysfunction can also be linked to other conditions common in men with diabetes, such as high blood pressure and coronary artery disease.

Having erectile dysfunction can be a real challenge. It can leave you and your partner feeling frustrated and discouraged. Take steps to cope with erectile dysfunction — and get your sex life back on track.

Many men are reluctant to discuss erectile dysfunction with their doctors. But don't let embarrassment keep you from getting help. One small conversation can make a big difference. Here's what to do:

Ask what you need to do to control diabetes. Careful blood sugar control can prevent nerve and blood vessel damage that can lead to erectile dysfunction. Ask your doctor if you're taking the right steps to manage your diabetes.

Ask about other health problems. It's common for men with diabetes to have other chronic conditions that can cause or worsen erectile dysfunction. Work with your doctor to make sure you're addressing any other health problems.

Check your medications. Ask your doctor if you're taking any medications that might be worsening your erectile problems, such as drugs used to treat depression or high blood pressure. Making a change to your medications may help.

Seek counseling. Anxiety and stress can worsen erectile dysfunction. A psychologist or other mental health provider can help you find ways to ease your stress level.

A number of erectile dysfunction treatments are available. Ask your doctor if one of these may be a good choice for you:

Oral medications. Erectile dysfunction medications include sildenafil (Viagra, Revatio), tadalafil (Cialis, Adcirca), vardenafil (Levitra, Staxyn) or Avanafil (Stendra). These pills can help ease blood flow to your penis, making it easier to get and keep an erection. Check with your doctor to see whether one of these medications is a safe choice for you.

Other medications. If pills aren't a good option for you, your doctor might recommend a tiny suppository you insert into the tip of your penis before sex. Another possibility is medication you inject into the base or side of your penis. Like oral medications, these drugs increase blood flow that helps you get and maintain an erection.

Vacuum-constriction device. This device, also called a penis pump or a vacuum pump, is a hollow tube you put over your penis. It uses a pump to draw blood into your penis to create an erection. This hand- or battery-powered device is simple to operate and has a low risk of problems.

If a vacuum-constriction device is a good treatment choice for you, your doctor might recommend or prescribe a specific model. That way, you can be sure it suits your needs and that it's made by a reputable manufacturer. Penis pumps available in magazines and sex ads might not be safe or effective.

Penile implants. In cases where medications or a penis pump won't work, a surgical penis implant might be an option. Semirigid or inflatable penile implants are a safe and effective treatment for many men with erectile dysfunction.

Don't underestimate the difference a few changes can make. Try these approaches to improve erectile dysfunction and your overall health:

Stop smoking. Tobacco use, including smoking, narrows your blood vessels, which can lead to or worsen erectile dysfunction. Smoking can also decrease levels of the chemical nitric oxide, which signals your body to allow blood flow to your penis.

If you've tried to quit on your own but couldn't, don't give up — ask for help. There are a number of strategies to help you quit, including medications.

Include physical activity in your daily routine. Exercise can help with underlying conditions that play a part in erectile dysfunction in a number of ways, including reducing stress, helping you lose weight and increasing blood flow.

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